Outtakes, Part 4: Are Parents the Cause of a Child’s Psychological Problems?

For the introduction to the ‘Outtakes’ series and to learn why it exists, click here.

Some of this material will likely be in the book, but in a much different (i.e., better) format. Since I am not an expert on child psychology , I went to Dr. John for a more seasoned take on therapy with children. When I asked him about the difficulties on working with children, he gave me a fairly scathing diatribe about parents and their role in child/adolescent pathology. I scribbled out as many notes as I could while he ranted/drank vodka, and I tried to put his voice into something remotely cohesive. His points are better than his jokes. Take a look and my apologies for John in advance if you are a good parent:

“While it is possible to present hundreds of case studies on children, there really is no point, because they all tend to boil down to a few important themes:

1) Parents do not want to be told that they have to do something differently.

Mom: I spank them, I yell at them, I throw things, I give them time-outs, and they still won’t stop fighting with each other. Fix them!

Dr. John: I understand what you’re saying. But hitting and screaming are basically just forms of punishment and, as we’ve gone over multiple (twenty-three) times, punishment does not work in the long run. It’s basically just abuse and traumatizing.

Mom: My parents hit me when I was a kid, and it worked! They’ll listen if I punish them.

Dr. John: So why are you here, then?

Mom: (silence)

2) Parents do not like to utilize reward systems to change behaviors.

Dr. John: Okay, for every day that your child doesn’t hit you in the back of the knee with a stick, you need to reward him.

Dad: What?! That’s just bribery! He should know that you’re not supposed to do that!

Dr. John: (yes, he should, but you didn’t do a very good job of teaching him that, which is why you’re here.) I understand that, but for some reason he doesn’t quite see that. What we are doing is providing him what is called an “extrinsic reward,” such as his favorite food, time with his video games, tokens that he can utilize later to buy something that will allow to feel positive about himself because he’s “earned” it. You pair that with lots of praise for a job well done, which is called an “intrinsic reward.” Over time, we decrease the frequency and value of the extrinsic rewards and increase the intrinsic rewards. That way you’re not really “bribing” him, at least not over the long haul, because your praise and improved relations with him will be the long-term reward for him. This will have wonderful effects on his self-esteem.

Dad: That’s ridiculous! My parents never did that with me, and I never, ever hit them or anyone else. I don’t even yell or have an anger problem, for Christ’s sake!!

Any parent who enlists the aid of a competent therapist to cope with some problem their child is experiencing must agree to actively participate in the therapy. That doesn’t mean you have to sit in on every session, week after week, but you do need to meet with the therapist periodically to learn how you can help your child put into practice what has been discussed during the child’s therapy. You cannot deny the role you must play in your child’s development. I’ve had parents whose idea of a meeting was to tell me to “get the little bastard to shape up” in the first session and leave. Then they do nothing more than drop off their child each week and drive away before I have any chance to speak with them. These parents tend to talk to me only when their insurance will not reimburse them in a timely fashion.

4) Parents don’t recognize that certain things can’t be changed.

In my practice I’ve seen many bright children who possessed reasonable amounts of insight toward problems that are solvable: depression, anxiety, relationships, venting about parents, poor grades, post 9/11 fears and more. But for many parents, merely treating these issues doesn’t go far enough. They want the Full Monty and then some:

Dad: Yes, she’s not having sex with the gardener anymore, but she gets straight C’s in school. Do something!!!

This girl is basically developmentally handicapped.

Dr. John: Sir, I understand your concern, but your daughter has an I.Q. of 77, which is well below average. These tests are not perfect by any means, but kids of her age with a score of 77 are actually more likely to get D’s and be held back. She works so hard to get her grades, she’s making the most of a horrible situation. I think that she should be praised.

Dad: My wife, mistress, and I have been over this multiple times, and we all agree, as do you as of right now. She…will…go…to…Harvard.

5) Parents don’t understand the term “consistency.”

When parents are given tips on changing a child’s behavior, I tell them that being inconsistent with these tools, is just as bad as not using them at all. I usually use the same example to highlight this:

“If you have a toddler who screams and yells until you give him a lollipop, he learns that this behavior is useful to obtain what he wants. If you withhold the lollipop when he does this, he may actually scream and yell more at first, because he is unclear why his usual method is not working. However, this behavior will not last, which is called “extinction.” Extinction is the goal, but you must understand that it is not likely to be a permanent solution if you are not capable of following through each and every time. In fact, if you eventually give in, especially on a sporadic basis, the child will learn that if he increases his yelling and screaming, he will get what he wants, sooner or later. So, in effect, you are actually making the behavior worse by not consistently following through on our behavioral plan. This is a similar process to what you might see in Las Vegas when you play the slot machines. If you were to not get what you wanted every time you put in your quarter, you would eventually stop playing (extinction). But since the casinos want your money, they will give you want you want every once in a while. And, to make it worse, they give you a reward without any predictable pattern. This, of course, keeps you sitting there at the machine, putting in quarters. A child with a temper problem experiences the same thing, minus the alcohol and dry eyes and hot waitresses and pit bosses. Does this all make sense?”

Of course, every mom and dad nods his or her head vigorously, as if they’ve just been empowered to raise an entire litter of small urchins. Do they ever follow-through? No, they do not:

Parent: I did it like 6 or 7 times in a row, and it worked pretty well, but like you said, it did get a little worse, and I caved in and bought him the truck.

Dr. John: Why did you do that?

Parent: He just got so Goddamn loud in the store. But it’s going to be okay, because I told him ‘this is THE last time young man, do you understand?’ And he nodded! So I think we’ll be okay from here on in.”

6) Some children simply despise their parents.

It’s just a sad fact of life. The days of respecting, caring for and loving your parents simply because of who they are do not necessarily apply in this day and age. Actually, that was probably true even when I was a teenager, but I don’t think I noticed it as much back then. I’ve met more than my fair share of very nice, polite parents with great values who want nothing but the best for their children. However, that doesn’t translate to being well-liked by said children. While some of these parents can often be too much of something in their love (e.g., overly doting, spoiling, too conservative with rules and regulations, overly involved in their children’s schoolwork and friends), they clearly do not deserve such harsh words and hatred from their children. However, time and time again kids come in and tell me that they simply loathe their parents, and it truly seems as if there is nothing the parents can do about it, other than perhaps die. And if this isn’t enough, the sheer hate more often than not translates to behavioral problems, from the more benign comments such as “leave me alone, it’s none of your business how school was today,” to the more unnerving, “I didn’t go to school today. I was at Bed, Bath and Beyond buying this Henckel’s knife to plunge into your heart.”

I’d like to thank John for his time and…candor.

As a warning to parents, if your child’s therapist is like Dr. John (or at least as cantankerous), you may not want to ask about the hardest part of working with your child. Unless, of course, you are prepared for the real answer: you.

16 Responses to “Outtakes, Part 4: Are Parents the Cause of a Child’s Psychological Problems?”

re #6: Some parents just suck as people. I don’t see why the parental relationship gets you a pass on just being generally hate-worthy. Plenty of assholes have kids, and you can’t blame the kids for having asshole parents or recognizing what their parents are like.

With any other people you encounter in the world, if you don’t like them you can generally avoid them. But if your parents suck, you still have to spend a ton of time with them and accept that they control your life. I can understand how that would develop into hate.

Parents do screw up their kids. Even my dad, who’s a great dad and a wonderful person, can be a royal bastard at times. Every human being is awful once in a while. But this is good general advice on parenting. Consistency may be the most important part of being a parent.

As a child/adolescent therapist, I agree totally! My favorite is when the kid is 15 or 16 and the depression has lifted, the parents say “Oh, but he still gives me an attitude about chores. Can you please talk to him about that.”

Well – he is 15! That is typical and you should be happy!

Parents never follow through with reward charts! I always get the response, “oh we have tried charts but they haven’t worked.”

Growing up catholic puts you in something of a strange place regarding mental health. For the longest time through high school and middle school all the way to how I made all of my college path decisions were driven by catholic/mother guilt. After a high school incident I started seeing a therapist and my mother was #3 on this list. To the point that she asked me “so are you fixed yet?” On the way home from a session and I just snapped out of it and resolved to figure it out, which I’ve been able to do with tools from my therapist. Several years later it came out that my sister is also clinically depressed, in a more severe way than I. And my mother finally started taking it seriously. After continuing to read about it I’m pretty sure she’s undiagnosed herself and it’s like pulling teeth to get her to go to the doctor. What is my point of all of this? Yes, parents can really mess up their kids. It’s work to remind myself that I don’t have to feel like crap about every decsision I make because it’s not enough. As long as folks like Dr. Rob are here to help keep the conversation going we’re in the right direction.

I think my mother-daughter relationship falls between #4 and #6. My mom doesn’t seem to want to accept our differences in personalities and tastes. She prefers to pound me into either becoming exactly like her or her fantasy child. The more I resist, the closer to #6 I get.

I love my mom because she’s my mother, and she’s been a pretty good mom overall. But most days, I just absolutely dislike her, and so we rarely talk.

But this is infinitely better than my father-daughter relationship which is nonexistent aside from a recently ignored Facebook friend request.

Yikes! There are many children and parents who need help, but are they going to get it from Dr John? His negative cognitions about parents, and therapeutic approaches to children (e.g., rewards) are troubling. It’s no wonder he’s “cantankerous.” Does Dr John like being told he needs to do something different? Try the Natural Child website or the Center for Non-Violent Communication for inspiration.

This is strong stuff and I can’t help but wonder why it’s ending up on your ‘B-Sides’ from your book. This sort of dark and sardonic yet insightful post is what drew me in to your blog in the first place. Please tell me the book is going to have more of this stuff, but better, and that’s why this entry is here and not in the final cut.

@Frank: Thanks for the praise, and yes, the plan is to have better versions of this stuff in the book. What really sucks about the whole process is that you can have very good material that doesn’t ‘fit’ with the project as a whole, as well as the reverse. I’m quickly learning that writing a book is starkly different than a series of blog entries. But the goal is not to disappoint, and I feel confident with that plan. If that fails, however, at least you would have gotten to read a bunch of semi-worthwhile material for fre…

When I was in high school and college, I figured the about 90% of kids with problems had some messed up, dysfunctional parents. The other 10% probably had some chemical imbalance that wasn’t anyone’s fault. Since then, nothing has changed my opinion.

I’ve never gotten close to someone who seemed to hate their parents “for no reason” without finding out that their parents are completely insane when in the privacy of the home. There are those people who believe that you have to present a perfect face to the world, and that home is where you get to let out all your frustrations.
A consequence of that is that there are often so many people who seem normal and nice, and then when you get to be close friends or romantic partners they treat you like dirt. Why? Because they learned from their parents that “intimacy” just means a kind of ownership, and they’d rather be the abuser than the abused.
For instance: my closest high-school friend appeared to hate her parents needlessly. Her dad drove her where ever she needed and got her concert tickets every month. Her mom made her vegetarian foods despite a strong disagreement about her lifestyle. They let her have a dog. She didn’t have to do any chores. Sounds pretty good right? But when I got to know her, I realized that her parents only let her do things if it made them feel good about themselves. Her dad liked getting her things and driving her so that he could get in “face time” and then never be around otherwise. Her mom never even let her do chores, because she liked being able to say how much she did for the family and being able to clean (snoop in) her daughter’s room (often throwing out important things, washing clothes that were just set out for the next day and moving things to where they couldn’t be found). And they wouldn’t do important things for her (like not smoking in the living room because it triggered her migranes) if they didn’t feel like it.

Okay, I certainly am a bit late with commenting this post, but I have one question, not so related to this specific topic – I was wondering what do you therapists actually think about your patients. I mean, of course you have enough strenght and patience and broad minds to be honest and supportive, and I think it takes a much deeper level of understanding people than one average person does have; but just out of curiosity, I would have considered being a therapist, only if it wasn’t for the fact that when I see this kind of parents you described above, I would have enough self-control not to start yelling at them and really try to solve the issue, but inside I’d be full of loathe for people who think they can become parents without knowing anything about human mind and psychology.

I certainly see in your posts that you are not numb to these horrible human paterns, but is it just in order to cause laughter, or is it really also hard for you as if it’s for other people?

I think part of it is the parent thinking they’re a failure. They don’t want advice from someone else when they think they know their kid inside and out. They don’t want to accept that sometimes it is their fault, and not the child being disagreeable.

The kid’s in therapy, not them, so why do they have to change? Why can’t the therapist give their kid a decent talking-to (not how therapy works at all) so that they’ll behave?

Even if the child is given tools, it can be really difficult when they have to constantly use them because the parent is the main cause of their current issues.